5% of Hypertension Cases can be Prevented

Checking Blood Pressure. Image credit to Shogo Green

We discussed hypertension in one of our tutorials in Internal Medicine II clinical posting this week, probably on Monday, and this was where I first brought up the news--even the resident doctor taking us was a bit surprised not because a medical student said something he has not heard before, but because of the very complex nature of hypertension in terms of its management based on multiple published studies he must have read about.

Back to the tutorial discussion. We discussed the various guidelines for the the definition and classification of hypertension; the various proposed mechanisms underlying its occurrence, and the documented fact that as much as between 90 and 95% of all hypertension cases have not been found (with current research--I say so because I believe with further sophistication in technologies geared towards scientific research in this area and much deeper foresight and insight coming to researchers, we may just begin to get fortunate) to have a specific known cause: that is one single definable underlying structural and functional error. This means that most people diagnosed with hypertension (consistent blood pressure at or greater than 140/90mmHg measured at two or more separate occasions, preferably weeks apart) will be on lifestyle modification and antihypertensive drug treatment probably for the rest of their lives. That's so unfortunate.

Hypertension. Image credit to Medicine Net

But I think some people, let me say some families with an established history of hypertension could actually prevent their kids from having this clinical condition in later life; however, it is if such a family is lucky to fall within the small percentage under the 90-95% class of hypertension of unknown cause that research is bringing a ray of hope to.

In a research published on 4th August 2013 in the journal Nature Genetics and headed by clinical pharmacologists from University of Cambridge and Addenbrooke's Hospital, it is shown that 5% of hypertension cases can prevented. Scientists from laboratories in four European countries collaborated in the study in which the Cambridge University team developed a newer and more powerful PET-CT scan (Positron Emission Tomography-Computed Tomography--they use radiations like x-rays and positron, a subatomic particle to produce functional images of the body's internal structures) that was used to image the adrenal glands (two small structures on top of the kidney which produce adrenalin, cortisol and aldosterone--aldosterone is involved in blood pressure regulation) for benign tumours. These benign adrenal tumours were found to have mutations--which the researchers sequenced using the latest gene sequencing technology--that cause hypertension through a direct mechanism also revealed by the study. The researchers predict that this benign tumour is the likely cause of hypertension for 1 in 20 patients with hypertension, and they affirm that this group of people if diagnosed with this benign adrenal tumour at a young age can have them removed, hence averting the development of hypertension in these people later in life.

I guess we are already beginning to get fortunate.